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Abstract(s)
Introdução: Em pacientes do sexo feminino com cancro da mama, o Ca 15.3 é amplamente
pedido, sendo especialmente usado como indicador de prognóstico e no follow-up de doentes
tratadas ou em tratamento.
Objetivos: O objetivo principal desta investigação é conhecer em que situações tem sido
pedido o Ca 15.3 no Centro Hospitalar Cova da Beira, no sentido de se tirarem conclusões de
forma a melhorar a rentabilidade e a utilização deste marcador tumoral.
Materiais e Métodos: Foram consultados 1704 processos correspondentes a todos os doentes a
quem foi requisitada a determinação do Ca 15.3, entre os anos de 2007 e 2008 (período de 21
meses). Foi realizado o estudo das variáveis: sexo; idade; valor sérico do Ca 15.3 no primeiro
registo; valores séricos dos marcadores CEA e Ca 125; resultados histológicos; diagnóstico
principal atribuído a cada paciente e contextos em que foram pedidas as determinações do
valor sérico do Ca 15.3. O estudo incluiu análise estatística descritiva e comparativa.
Resultados: Foram observados 1704 casos num total de 2081 determinações do Ca 15.3.
Foram pedidos 985 valores séricos, cuja média foi de 22,1 U/ml, e 708 valores séricos, cuja
média foi de 29,15 U/ml, para o ambulatório e internamento, respetivamente. Dos 1704 casos
analisados, 73% foram do sexo feminino e 27% do masculino; 9,6% foram de cancro da mama,
cuja média foi de 37,43 U/ml; 6,9% de cancro do cólon-reto, cuja média foi de 20,94 U/ml;
2,6% de cancro gástrico, cuja média foi de 16,65 U/ml; 2,3% de cancro pulmonar, cuja média
foi de 72,15 U/ml; 2,3% foram de cancro hepático, cuja média foi de 61,61 U/ml; 0,8% de
cancro do endométrio, cuja média foi de 48,71 U/ml; 0,6% de cancro pancreático, cuja média
foi de 42,13 U/ml; 0,6% de cancro da próstata, cuja média foi de 31,59 U/ml; 65% dos casos
apresentou doença benigna, cuja média foi de 21,13U/ml e 9,15% realizaram biópsia que
serviu de orientação para o diagnóstico. Quando o Ca 15.3 foi associado ao CEA e ao Ca 125,
43,4% dos casos apresentou valores normais. As médias dos valores séricos foram muito
variáveis em função da idade dos grupos etários, destacando os grupos com idades mais
elevadas.
Conclusão: Os nossos resultados revelaram que o Ca 15.3 apresentou uma baixa sensibilidade
e especificidade para o diagnóstico das várias patologias nas quais o marcador foi pedido
muito frequentemente. Sugerimos, assim, que no Hospital Universitário da Cova da Beira este
marcador só deve ser usado em conformidade com as recentes Guidelines.
Background: In female patients with breast cancer, the Ca 15.3 is widely used, being especially requested as a prognostic indicator and in the follow-up of patients treated or in treatment. Objective: To determine in which situations the Ca 15.3 as been requested, so that it could be possible to improve the usefulness of this tumor marker in clinical practice and the best way of using it, in Hospital Universit·rio da Cova da Beira. Materials and Methods: 1704 clinical processes, corresponding to all patients who were asked to determine the Ca 15.3, were consulted between the years 2007 and 2008 (21 months). The variables studied were: sex; age; serum value of Ca 15.3 in its first register; serum values of CEA and CA 125 marker; histopathology results; primary diagnosis of each patient and which context were the diagnostic tests, were requested. This analysis included descriptive, comparative and inferential statistics. Results: 1704 cases were observed in a total of 2081 determinations of the Ca 15.3. 985 serum analysis were asked in consultation (the average of Ca 15.3 serum values was 22,1 U/ml) and 708 in hospitalization (29,15 U/ml). In the 1704 cases: 73% were female patients and 27% were male patients (22,05 U/ml e 21,94 U/ml); 164 (9,6%) were breast cancer (37,43 U/ml); 118 were colon-rectal cancer (20,94 U/ml); 45 were stomach cancer (16,65U/ml); 39 were lung cancer (72,15 U/ml); 14 endometrial cancer (48,71 U/ml); 11 hepatic cancer (61,61 U/ml); 10 pancreatic cancer (42,13 U/ml); 10 were prostate cancer (31,59 U/ml); 1107 had benign pathologies (21,13U/ml) and 9,15% had histological result for diagnosis guidance. When the Ca 15.3 was asked with the CEA and the Ca 125, 43,4% revealed normal values . As the age in the various age groups rises, averages of the serum values became more unequal (29,27 U/ml at the age group of 70-79 years, 34,28 U/ml of the 80-89 years and 25,31 of 90- 109 years). Conclusion: Our results revealed that the utilization of the tumor marker Ca 15.3 has a low specificity and sensibility in the diagnostic of many pathologies for which it is not recommended in the latest Guidelines. This prove suggests that, in the Hospital Universit·rio da Cova da Beira, where the Ca 15.3 has been very often asked for the diagnosis of many pathologies, it should be used according to the latest Guidelines, in the follow-up of breast cancer patients treatment.
Background: In female patients with breast cancer, the Ca 15.3 is widely used, being especially requested as a prognostic indicator and in the follow-up of patients treated or in treatment. Objective: To determine in which situations the Ca 15.3 as been requested, so that it could be possible to improve the usefulness of this tumor marker in clinical practice and the best way of using it, in Hospital Universit·rio da Cova da Beira. Materials and Methods: 1704 clinical processes, corresponding to all patients who were asked to determine the Ca 15.3, were consulted between the years 2007 and 2008 (21 months). The variables studied were: sex; age; serum value of Ca 15.3 in its first register; serum values of CEA and CA 125 marker; histopathology results; primary diagnosis of each patient and which context were the diagnostic tests, were requested. This analysis included descriptive, comparative and inferential statistics. Results: 1704 cases were observed in a total of 2081 determinations of the Ca 15.3. 985 serum analysis were asked in consultation (the average of Ca 15.3 serum values was 22,1 U/ml) and 708 in hospitalization (29,15 U/ml). In the 1704 cases: 73% were female patients and 27% were male patients (22,05 U/ml e 21,94 U/ml); 164 (9,6%) were breast cancer (37,43 U/ml); 118 were colon-rectal cancer (20,94 U/ml); 45 were stomach cancer (16,65U/ml); 39 were lung cancer (72,15 U/ml); 14 endometrial cancer (48,71 U/ml); 11 hepatic cancer (61,61 U/ml); 10 pancreatic cancer (42,13 U/ml); 10 were prostate cancer (31,59 U/ml); 1107 had benign pathologies (21,13U/ml) and 9,15% had histological result for diagnosis guidance. When the Ca 15.3 was asked with the CEA and the Ca 125, 43,4% revealed normal values . As the age in the various age groups rises, averages of the serum values became more unequal (29,27 U/ml at the age group of 70-79 years, 34,28 U/ml of the 80-89 years and 25,31 of 90- 109 years). Conclusion: Our results revealed that the utilization of the tumor marker Ca 15.3 has a low specificity and sensibility in the diagnostic of many pathologies for which it is not recommended in the latest Guidelines. This prove suggests that, in the Hospital Universit·rio da Cova da Beira, where the Ca 15.3 has been very often asked for the diagnosis of many pathologies, it should be used according to the latest Guidelines, in the follow-up of breast cancer patients treatment.
Description
Keywords
CA 15.3 CA 15.3 - Marcadores tumorais Cancro da mama Patologias benignas Patologias malignas
Citation
Publisher
Universidade da Beira Interior